Quebec this week advanced the acceptance of psychedelic therapies by becoming the first governing medical body in Canada to publicly fund medical psilocybin-assisted psychotherapy. The move marks a milestone in the recognition of psilocybin, the primary psychoactive in “magic mushrooms,” and sets a precedent for other Canadian provinces to take similar action.
“This decision is a huge step forward for the use of psilocybin-assisted psychotherapy as a legitimate medical treatment, TheraPsil, a nonprofit group that advocates for the advancement of psilocybin therapies, wrote in a statement on December 15. “It not only provides greater access to this potentially life-changing treatment for patients in Quebec, but it also sets a precedent for other provinces to follow suit.”
Clinical research and other studies into psychedelics such as psilocybin have shown that the drugs have potential therapeutic benefits, particularly for serious mental health conditions such as depression, addiction and anxiety. Research published in the peer-reviewed journal JAMA Psychiatry in 2020 found that psilocybin-assisted psychotherapy was an effective and quick-acting treatment for a group of 24 participants with major depressive disorder. A separate study published in 2016 determined that psilocybin treatment produced substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer.
Despite the potential of psilocybin to treat serious mental health conditions, access to psilocybin and psilocybin-assisted psychotherapy is extremely limited in Canada. Some terminally ill patients suffering from palliative depression have waited more than a year for a response from Health Canada, the national health regulator, to use psilocybin legally. And until now, even when patients have a legal exemption, healthcare practitioners were not permitted to bill for the treatment due to a lack of codes to properly process charges for two therapists, a standard practice for psychedelic-assisted therapy put in place to help ensure standards of care and ethical treatment of patients.
Province Agrees To Cover Bills For Psilocybin Therapy
That situation changed, however, when two doctors, Dr. Houman Farzin and Dr. Jean-François Stephan, successfully billed for and were paid by the province of Quebec after completing psilocybin-assisted psychotherapy treatment for a patient with legal access granted by Health Canada. The patient, who has a medical exemption to use psilocybin, was treated in June of this year.
After the treatment, Dr. Stephan compiled evidence and submitted a letter, cosigned by 15 colleagues, outlining the medical safety and efficacy of psilocybin. He argued that both doctors participating in the treatment should be covered, noting that existing codes would not allow two doctors to bill for the same patient at the same time. He also explained that scientific evidence demonstrates that patients who have legal access to psilocybin-assisted psychotherapy have a medical indication.
Dr. Stephan partnered with the governing body for general practitioners in Québec, the Fédération des médecins omnipraticiens du Québec (FMOQ), which negotiated with the government to amend the codes. The professional association agreed that psilocybin-assisted psychotherapy is a medically insured service, which made it possible for the Ministère de la Santé et des Services sociaux (MSSS) to amend the existing codes and charge for the therapy session.
“I think it’s amazing news that patients have covered access to such an important treatment option and it’s an encouraging sign for psychedelic medicine. Quebec has chosen to align with the science in regards to psychedelic medicine and recognize it as a medically indicated service in specific circumstances. They didn’t delay this unnecessarily,” said Stephan. “It’s encouraging to see them recognize the evidence available, and make the necessary adjustments to support the financial aspects of treatment so that it’s not an obstacle for patient access. I’m pleased this happened in Quebec, and I hope other provinces follow in their footsteps.”
Robert Foxman, the patient treated with psilocybin-assisted therapy by Dr. Farzin and Dr. Stephan, lauded the provincial government agency that approved health coverage for his medical care.
“I’m extremely happy that RAMQ, the medical billing department of the Quebec government, set a precedent with my June 11th Section 56 psilocybin session, by paying both of my wonderful guides, Dr. Houman Farzin and Dr. Jean-François Stephan, for their well-earned work,” Foxman said. “My hope is that many more deserving people like me will be able to undergo this therapy now that it’s fully covered in Quebec, and I would like to see other Canadian provinces step up to the plate and follow Quebec’s suit.”